HomeMy WebLinkAbout001103 1 ..rm S. , .. , t . . , v , .'nt"relln.`,f^P! 'r.'�°1^-' 'W'-.°.� „ 'Rw"n+�..tr'�P ^tq,r w .T'."P TF .T•°>M�'� °'Arrnn^rr *n or
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GARFIELD COUNTY B Q AND SANITATION DEPARTMENT In .
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Phone' l Glenwood $+ d e'.�1oloredo 81601 t 1 ill " r
1 Vj 1 O n e 56241
803104
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This does not con1 11Uk E
l ' 1 INDIVIDUAL SEWAGE DISPOSAL PERMIT MO 1 � 93 a building or use,permlt ,1il
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IdlI Mark Bearwald dl.
System Location Ref 112 PArhr pols C n Ili Y y 1 i y I1 1 1 , 11111111 , 11,
1 ,0 I 0477 ,Cn ll Licensed Installer ` ° ry N 14h1 1 , "
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Conditional Construction' approval is h granted fort 1 ,000 gallon I nI V �
I T— Septic Tank or Aerated treatments i ;i �
I , rl i d with dry we'll
I ' Absorption area (or dispersal area) computed as follows: 1 , "(1d ill -1 I ,
mi l Perc rate of one inch in �� minutes requires a mini um, of _ NA- sq. ft. of absorption area per bedroom.' N1 I 1 , f l lh Ho
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I Therefore the no. of bedrooms / x A _ sq. ft, inimum requirement v a total of 4/A sq. ft. of atsorption arse. I I IIWI i re,, �
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1 May we suggest y .1 4 e xi s7�i n y �� + ' cr< � 911 il 1 11 Date /0/ ¢ /g' / Il Inspector / Jl! " -. i it ` / {^ e
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FINAL APPROVAL OF SYSTEM: i1 ■
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411099 I I iIMali
No system shall be deemed to be in compliance with the wage Disposal Laws until the assembled system is approved prior to'coO
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lil ing any part. iIr 1Iri 4
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Se ptic Tank access for inspection and pi rung within 12" of ground surface or aerated access ports above ground u
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Trade name of septic tank or aerated trea unit. / , a. � 'O 1 i
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.? i 7 . Adequate absorption (or dispersal) area. ,1 1! um
• �9 K Adequate compliance with permit requir l aments.
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Adequate compliance with County and State regulations/requirements. ts, a s I �.
r °rte Other q /, N' n h I
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Date /� / S�J / Inspector
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RETAIN WITH RECEIPT RECORDS 'AT C S STRUCTION SITE µ f,
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"CONDITIONS: f
1. All installation must comply with all requirements of t County Individual Sewage Disposal Regulations, adopted pursuant 9:9:,'
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thority granted in 66-44-4, CRS 1963, amended 66314, AS 1963. � ,11,1-
rii 2. This permit is valid only for connection to structures loll bete fully complied .with County toning and building requirements U r 1 w.,
Connection to or use with any dwelling or structures no approved by the Building and Zoning Office shall automatically be a lviole w'l lil1el°
tion of a requirement of the permit and cause for both I al action and revocation of the permit, a i I o �
3. Section III, 3.24 requires any person who constructs; M Ors, or installs an individual sewage disposal system in a manner which in'nll p "1�
volves a knowing and material variation from the term r specifications contained in the application of permit commits a CIasj l4 III I Ii
Petty Offense ($500.00 fine -- I N 6 months in jail or both). kt
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16 \ { Applicant: Ora c a D"Wrtnentt
l- Pink Copy I 11 °illl
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INDIVIDUAL HOME SEWAGE TREATMENT SYSTEMS APPLICATION IDatekbt(Sygt
Owner: Wb \ . \\ l
£ *1 Address :C'�i{ ll (°� _ u�„ City :QC��`1n,\Q Zip: Phone:
INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW
Attach separate sheets or report showing entire area with respect to surrounding areas,
topography of area, habitable buildings, location of potable water wells, soil percola-
tion test holes, soil profiles in test holes (see Page 3).
Near What
1. Location of Facility: County GARFIELD City or Town \M\t3 ct,c. c& t.\ .
Location Address & /or p/ q
Legal Description Lot Size LO0 1-k
2. No. of Bedrooms 4 3 Septic Tank Capacity` k5C_SC ' Aeration Unit Capacity N/A
3. Source of Domestic Water: Public (name):
Private: Well ' Depth Other Depth to 1st ground water table
4. Is facility within boundaries of a city /town or sanitation district? ■\
5. Distance to nearest sewer system: 1 rnt\ A, s
Have you attempted to arrange a connection with the system? Y\Ca
If rejected, what was the reason?
6. If R.P.E. tested, state rate of absorption in test holes shown on the location map, in
minutes per inch of drop in water level after holes have been soaked for 24 hours:
7. Name, address, and telephone of R.P.E. who made soil absorption tests:
8. Name, address, and telephone of R.P.E. responsible for design of the system:
9. Express permission is hereby granted for the inspection of the above property by any
member of the Garfield County Building & Sanitation Department and /or such persons as
they may designate. Any withdrawal of this permission shall be in writing and receipt
acknowledged by the County Building & Sanitation Department.
10. I have been given an opportunity to read the Individual Sewage Disposal Systems Regula-
tions of Garfield County and I hereby agree to comply with all terms, conditions and
requirements included therein.
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16 15 gt
' f Date Sig ature of Applicant
(TO BE RETURNED TO BLDG. & SANI. DEPT.)
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